| NPI | 1609208180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 016568) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 23016568) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2021-01-11 |